Treatment of Elderly Femoral Intertrochanteric Fracture by InterTan Intramedullary Nail and PFNA
Zhengbing Su, Minghui Yang, Gang Luo, Linlin Liang, Yong Hao
Abstract
To analyze the treatment of elderly femoral intertrochanteric fracture (EFIF) using InterTan intramedullary nail (InterTanIN) and proximal femoral nail antirotation (PFNA). A total of 75 patients suffering from EFIF receiving intramedullary fixation were retrospectively collected. According to intramedullary fixation methods, the patients were separated into InterTanIN group and PFNA group. Parameters including the surgery time, blood loss, number of X-ray fluoroscopy, hospital stays, bone-healing time, postoperative Harris hip score (HIS) (1 month, 3 months, 6 months, and 12 months), and complications were collected and analyzed. The results showed surgery time, blood loss, and number of X-ray fluoroscopy in InterTanIN group were higher than those in PFNA group ( <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mi>P</a:mi> <a:mo><</a:mo> <a:mn>0.05</a:mn> </a:math> ). The mean hospital stay in the InterTanIN group was comparable to that in the PFNA group ( <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"> <c:mi>P</c:mi> <c:mo>></c:mo> <c:mn>0.05</c:mn> </c:math> ). There was no significant difference in bone-healing time between the InterTanIN group and PFNA group ( <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"> <e:mi>P</e:mi> <e:mo>></e:mo> <e:mn>0.05</e:mn> </e:math> ). The postoperative HIS of InterTanIN group was statistically better than PFNA group at the 3rd month and the 6th month ( <g:math xmlns:g="http://www.w3.org/1998/Math/MathML" id="M4"> <g:mi>P</g:mi> <g:mo><</g:mo> <g:mn>0.05</g:mn> </g:math> ). With the extension of recovery time, the gap between the two groups gradually narrowed. The postoperative implant displacement happened more often in the PFNA group than in the InterTanIN group. EFIF treated with InterTanIN or PFNA could achieve good long-term efficacy. Although InterTanIN has the disadvantages of increased operative time, blood loss, and radiation exposure compared to PFNA, the postoperative hip function recovery of InterTanIN seems to be more reliable and stable than PFNA.